hospital treatment in exacerbation of COPD

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If hospital treatment is indicated then:

  • investigations include:
    • echest X-ray
    • arterial blood gases (record inspired oxygen concentration)
    • ECG
    • blood tests
      • Full blood count and urea and electrolytes
      • Theophylline level if patient on theophylline at admission
      • Sputum microscopy and culture if purulent
  • further management
    • give oxygen to keep SaO2 above 90%
    • assess need for non-invasive ventilation:
      • consider respiratory stimulant non-invasive ventilation not available
      • assess need for intubation
    • if poor response to nebulised bronchodilators then consider intravenous theophyllines

Once stable then consider for hospital-at-home or assisted-discharge scheme.

Before the patient is discharged then establish on optimal therapy and, if necessary, arrange multidisciplinary assessment.


  1. NICE (2004). Chronic obstructive pulmonary disease - management of chronic obstructive pulmonary disease in adults in primary care and secondary care

Last reviewed 01/2018